Learning Disabilities

Introduction:
Learning disability is referred to as a hidden disability as children
with learning disabilities do not look handicapped and their
difficulties are not obvious. Hence, learning disabled children are
often misunderstood and accused of not listening, being lazy or
clumsy resulting in low self-esteem, confidence and motivation. So
we can consider the child to be suffering with learning disability
when he/she displays an educationally significant discrepancy
between his/her estimated intellectual potential and actual school
performance that cannot be explained in terms of intellectual
potential. These children may have a combination of difficulties in
speaking, listening, reading, comprehension, spelling, arithmetic
calculations, writing and concepts. Children with a learning disability
have average and sometimes above average intelligence.

History:
Learning disabilities has been the topic of study interest for more
than 100 years. Over time, more and more people have become
aware of due to the brain research (1930–1960) that became the
foundation of the field of learning disabilities. The terms such as
brain-injured child was first used by Alfred Strauss and Laura
Lehtinen. Although many researchers have contributed to the field,
the seminal works of two important scientists are phenomenal even
today. Adolf Kussmaul (1877), a German neurologist was the first to
identify reading disability and coined the term “word blindness.” He
defines it as “complete text blindness”, although the power of sight,
the intellect, and the powers of speech are intact.” Almost after
10 years after the term “word blindness” appeared, the term
‘dyslexia’ was used by Berlin (1887) to define reading challenges.
The other influential researcher, who has made great contributions
to the Learning Disability (LD) construct and develops understanding
of the various issues related to LD was Pringle Morgan in the United
Kingdom. The article by Pringle Morgan entitled “A Case of
Congenital Word Blindness” (Morgan, 1896) in the British Medical
Journal encouraged researchers and formed a basis for research to
study other cases of LD to further explore studies on the definitions
and identification tools of LD. Samuel A. Kirk was the first
Psychologist to use the term “learning disability” in the year 1963 in
Chicago at an education conference.
Definition:
According to The Learning Disabilities Association of America, a
learning disability is a neurological condition that interferes with
an individual’s ability to store, process, or produce information.

Affects the ability to listen, think, speak, read, write, and spell or
mathematical calculations. Does not include learning problems
resulted from visual, hearing or motor disabilities; or intellectual
disability, emotional disturbance, environmental cultural, or
economic disadvantage. Not a sign of poor intelligence or laziness.

Causes of Learning Disabilities:

Learning Disability is a neurodevelopmental disorder that are not
due to hearing or vision problems, social-economic factors, cultural
or linguistic differences, lack of motivation, insufficient or
unsatisfactory instruction. It is due to the interaction of genetic,
epigenetic, and environmental factors with a biological origin that
affects the brain’s ability to perceive and/or process verbal and non-
verbal information efficiently and accurately.

Learning disabilities are caused by differences in the neurological

functioning of the person’s brain. These differences can occur before
the person is born, during their birth, or in early childhood, and may
be caused by factors such as:
1) Genetic Factors: Many learning disabilities, such as dyslexia and
dyscalculia, have a genetic component, with certain genes increasing
susceptibility to these conditions. Family history plays a significant
role in the likelihood of developing a learning disability, as these
conditions often run in families.

2) Brain Development: Abnormalities or disruptions in brain

development during prenatal, perinatal, or postnatal stages can
contribute to learning disabilities.

Factors such as premature birth, prenatal exposure to toxins or

infections, and traumatic brain injury can affect the structure and
function of the brain, leading to learning difficulties.

3. Environmental Factors: Environmental influences, including early

childhood experiences, socioeconomic status, and access to quality
education, can impact cognitive development and contribute to
learning disabilities.
Lack of early intervention and support services may exacerbate
learning.

However, it’s important to note that learning disabilities should not

be mistaken for learning problems that arise due to other factors
such as:

 Visual, hearing, verbal, or motor handicaps

 Intellectual disability
 Emotional disturbances
 Economic, cultural, or environmental disadvantages
PENNINGTON’S NEUROPSYCHOLOGICAL MODEL OF LDs

Domain Location Disorder

Phonological Left perisylvian region Dyslexia

Processing

Executive Prefrontal Region ADD

Functions

Spatial Reasoning Posterior Right Math/Handwriting

Hemisphere

Social Cognition Limbic, Orbital, Right Autism spectrum

hemisphere

Long-term Hippocampus, Amygdala Memory disorder /

Memory Amnesia

Brain functions are modular which means that brain systems are
specialized for processing specific kinds of information and that
these modules are autonomous in function and neural
representation. These modules are differentially vulnerable if all
brain systems were equally vulnerable we should find equal numbers
of developmental disorders for each brain system – but we don’t.
Some areas are more vulnerable than others:
Exception – executive functions aren’t completely distinct from other
modules; they can affect how well modules function, partly because
they control attention.

Symptoms are divided into 4 categories:

1) Primary – core symptoms, universal, specific and persistent.
 2) Correlated – same etiology /affect different brain systems (e.g.,
autism and mental retardation – many have MR, but it is not
universal or specific to the disorder).
3) Secondary – consequences of primary or correlated symptoms
4) Artifactual – appear associated/not causally.

PENNINGTON’S FIVE FUNCTIONAL DOMAINS:

According to Pennington, these domains account for nearly all the

learning disorders.

1) Phonological Processing:
The perisylvian region includes Wernicke’s area in the posterior
left temporal lobe and Broca’s area in the premotor portion of
the frontal lobe.

2) Spatial Cognition:
This is modality specific, so blind children can still develop
spatial cognition. Functions in this domain include object
localization, spatial or visual memory, and attention to extra
personal space, mental rotations, and spatial construction.
There are several brain regions which sub serve this function
generation of visual information has a left posterior localization
transfer of information to long-term memory involves the
limbic system especially in the right hemisphere.
Although verbal knowledge shows continuing increases into the
later decades of life, spatial reasoning peaks in adolescence and
then slowly declines thereafter dyslexia – traditional beliefs feel
it represents some kind of visual or spatial problem, but recent
research has strongly shown that most dyslexics have impaired
phonological processing skills.

3) Executive Functions:
Developmentally – traditionally seen as occurring quite late in
normal brain development, but studies have shown there are
some important changes which occur during the second half of
 the 1st year. Development seems to roughly correspond to the
Piagetian stages of cognitive development. Thus the WCST will
be harder for pre-schoolers and early elementary children
because “number” is much less salient a dimension than form
or colour.

Risk Factors of Learning Disorder:

1) Genetics: Family history of learning disorders increases the
likelihood of a child being affected.
2) Prenatal Influences: Exposure to toxins, maternal substance
use, or complications during pregnancy can impact brain
development.
3) Birth Factors: Premature birth, low birth weight, or birth
trauma may contribute to learning difficulties.
4) Early Childhood Experiences: Lack of early stimulation or
exposure to environmental toxins can affect cognitive
development.
5) Neurological Factors: Differences in brain structure or function,
such as abnormal development in certain brain regions.
6) Environmental Factors: Socioeconomic status, quality of
education, and home environment can influence learning
abilities.
7) Medical Conditions: Conditions like ADHD, epilepsy, or sensory
impairments may co-occur with learning disorders.
8) Psychological Factors: Emotional trauma, chronic stress, or
mental health disorders can impact learning.

Classification of learning disorder:

Learning difficulties are classified at multiple levels, including
categorizing children as LD, usually achieving, or mentally inferior,
and within LD, as reading versus math impaired. LD is distinguished
from types of low achievement that are expected due to emotional
disturbance, social or cultural disadvantage, or inadequate
instruction, and is identified as a particular type of “unexpected” low
achievement across classes of presumed childhood conditions that
produce underachievement.
LD is rarely conceptualized as a single disability in any federal or non-
federal classification; rather, it is represented as a broad category
that includes difficulties in any one or a combination of academic
disciplines. The federal definition of 1968 specifies seven domains:
(1) listening; (2) speaking; (3) basic reading (decoding and word
recognition); (4) reading comprehension; (5) arithmetic calculation;
(6) mathematics reasoning; and (7) written expression. The inclusion
of these seven aspects of impairment in the federal classification
assures that the LD category encompasses a wide range of learning
issues and that the very diverse learning problems should be
grouped together. Even today, many studies simply label groups of
students as “learning disabled,” despite mounting evidence that LD
correlates with poor reading, math, and other subjects.
Types of learning disability:
Many mental health professionals, including the Learning
Impairments Association of America, consider the seven disorders
listed below to be unique learning disabilities. They identify Autism
Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder
(ADHD) as related but distinct learning disorders that impact
learning.

1. Dyslexia
2. Dysgraphia
3. Dyscalculia
4. Dyspraxia
5. Expressive Language
6. Receptive Language
7. Auditory processing disorder
8. Visual perceptual/visual motor deficit
9. Nonverbal learning disabilities
1) Dyslexia:
Dyslexia (also known as reading disability) a specific learning
disability that affects reading and related language-based processing
skills is the most common learning disability accounting for at least
80 per cent of all LDs. It can affect reading fluency; decoding, reading
comprehension, recall, writing, spelling, and sometimes speech and
can exist along with other related disorders. However, the severity
can differ in each individual and dyslexia sometimes is referred to as
a Language-Based Learning Disability.
The word “dyslexia” is of Greek origin, meaning “impaired”. Lyon
[Link] (2003) defined dyslexia as a SLD that is neurobiological in origin
and characterized by difficulties with inaccurate word recognition
and poor spelling and decoding abilities. These difficulties typically
result from a deficit in the phonological component of language.
Reading impairments are thought to be caused by phonological
processing problems, according to study (i.e., processing the sounds
of speech). Individuals with reading impairments frequently struggle
to decode words into separate sounds and/or blend sounds together
in order to read words fast and properly. These decoding issues
frequently lead to reading comprehension issue . During reading,
Magnetic resonance imaging (fMRI) reveals a different brain
activation profile confirming the etiology of Dyslexia to be
neurological and genetic causes. The left side of the brain is activated
by three systems: an anterior system in the left inferior frontal region
that affects phoneme production (articulating words silently or out
loud), a left parietotemporal system that analyses the written word,
and a left occipitotemporal system that performs automatic word
recognition. Dyslexic youngsters, on the other hand, show decreased
activation in both posterior systems (left temporoparietal, left
occipitotemporal), as well as increased activity in the left inferior
frontal gyrus, right temporal, and tempoparietal regions. As a result,
individuals continue to struggle to read unexpected words because
they rely more heavily on right-sided posterior brain regions to read
via memorization rather than sound–symbol links.
According to research, RD is highly familial and heritable. Up to 50%
of children with RD have the disorder, and 50% of siblings of a child
with RD have it as well. Twin studies have revealed strong
concordance rates for RD, indicating that genetic variables account
for 69 to 87 percent of the prevalence while environmental factors
account for 13 to 30 percent.

2) Dysgraphia: Dysgraphia is a learning disability which involves

impaired ability to produce legible and automatic letter writing and
often numeral writing, the latter of which may interfere with math.
Dysgraphia is rooted in difficulty with storing and automatically
retrieving letters and numerals. Individuals with dysgraphia often
have difficulties in Executive Functions (e.g., planning and
organizing).

3) Dyscalculia: Individuals with this type of learning disability

demonstrate impaired math calculation skills and difficulty
understanding numbers and math facts. Dyscalculia is associated
with weaknesses in fundamental number representation and
processing, which results in difficulties with quantifying sets without
counting, using nonverbal processes to complete simple numerical
operations, and estimating relative magnitudes of sets. Because
these math skills are necessary for higher-level math problem
solving, quantitative reasoning is likely impaired for these individuals.

4) Dyspraxia: A disorder that is characterized by difficulty in

muscle control, which causes problems with movement and
coordination, language and speech, and can affect learning.
Although not a learning disability, Dyspraxia often exists along
with Dyslexia, Dyscalculia or ADHD.
5) Expressive Language: (language-based): hard time expressing
thoughts verbally(finding the words when trying to express
yourself), poor reading comprehension, has trouble labeling
objects, talking and writing
 6) Receptive Language: knowing meanings of words or concepts,
but difficult to follow conversations,
7) Visual Processing Disorder (visual-based): cannot receive,
process, sequence, recall or express information in an accurate
and timely way. Misreads words, mistakes letters and numbers
that look similar in shape.
8) Audio Processing Difficulty: (auditory based) telling the
difference between sounds of letters or words, being able to
remember what was heard, and having inability to filter out
background noises. Misspells or mispronounces similar
sounding words.
9) Nonverbal learning disabilities (NVLD): NVLD is characterized
by difficulty interpreting nonverbal cues such as facial
expressions, body language, tone of voice, and other nonverbal
signals.

Symptoms of Learning Disabilities:

These are some of the symptoms of learning disabilities:

 Poor memory
 Difficulty focusing
 Short attention span
 Difficulty with reading or writing
 Inability to distinguish between sounds, letters, or numbers
 Difficulty sounding out words
 Tendency to put numbers or letters in the wrong sequence
 Difficulty telling time
 Confusion between right and left
 Tendency to reverse letters
 Difficulty grasping certain words and concepts
 Disconnect between words and meaning (i.e.. saying one thing
but meaning another)
 Difficulty expressing thoughts and emotions
 Poor hand-eye coordination
  Delayed speech development
 Disorganization
 Trouble with listening and following instructions
 Inappropriate responses
 Restlessness and impulsiveness
 Tendency to act out
 Difficulty with discipline
 Resistance to change
 Inconsistent performance on a daily or weekly basis

According to the National Institute for Learning Development

(NILD), frustration is a hallmark of this condition, since people with
learning disabilities often excel at some things but do very poorly in
other areas, and are often acutely aware of the gaps between what
they can and cannot do.
The NILD notes that people with learning disabilities often find
themselves failing in certain academic or professional areas due to
reasons beyond their control, or having to put in tremendous
amounts of effort in order to succeed. This experience can be
difficult, confusing, and demotivating, often causing the person to
feel sad and disappointed.
Associated Problems with Learning disabilities:
Learning Disabilities often coexist with other conditions, commonly
referred to as "associated conditions." These comorbid conditions
can complicate the learning process and impact emotional, social,
and behavioural functioning. Here’s a detailed explanation of some
of the associated conditions:

1) Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is one of the most common conditions associated with
learning disabilities. While ADHD itself is not a learning disability, it
significantly impacts a person’s ability to focus, organize, and process
information effectively.
Features of ADHD: Inattention: Difficulty focusing on tasks, being
easily distracted, and having trouble following through on
instructions.
Hyperactivity: Excessive movement, such as fidgeting, inability to
stay seated, or restlessness.
Impulsivity: Acting without thinking, interrupting others, or difficulty
waiting for a turn.
ADHD Interacts with Learning Disabilities: Children with ADHD may
struggle with sustained attention, making it harder to grasp and
retain information. Impulsive behaviour can interfere with classroom
dynamics and social interactions, further hindering learning.
Organizational and time-management challenges can exacerbate
difficulties with reading, writing, and math tasks.
2. Anxiety and Depression
Anxiety and depression are prevalent among individuals with
learning disabilities due to the stress and frustration of coping with
academic challenges.
Anxiety:
Triggers: Fear of failure, frustration from misunderstood abilities, or
pressure to perform academically.
Symptoms: Excessive worry, avoidance of school or challenging tasks,
physical symptoms like stomach aches or headaches, and trouble
concentrating. Impact on Learning: Anxiety can lead to
perfectionism, avoidance, or "freezing" during tests or assignments.
Depression:
Triggers: Feelings of inadequacy, repeated failures, or negative
feedback from peers and teachers.
Symptoms: Persistent sadness, low energy, irritability, and a lack of
interest in activities.
Impact on Learning: Depression can result in low motivation, poor
academic performance, and withdrawal from social interactions.
3. Behavioural and Emotional Disorders
Children with learning disabilities are at a higher risk for developing
behavioural and emotional disorders. These may manifest as
externalizing behaviours (e.g., aggression) or internalizing behaviours
(e.g., withdrawal).
Common Behavioural and Emotional Challenges:
Oppositional Defiant Disorder (ODD): Persistent defiance, arguing
with authority figures, or refusal to follow rules.
Conduct Disorder (CD): More severe behaviors, including aggression
toward others, property destruction, or rule violations.
Emotional Dysregulation: Difficulty managing emotions, leading to
outbursts or mood swings.
These Disorders Affect Learning:
Behaviour problems can disrupt the classroom environment and
reduce instructional time.
Emotional dysregulation can interfere with peer relationships,
leading to social isolation.
These disorders can compound feelings of frustration, leading to a
negative cycle of academic struggles and emotional outbursts.

Diagnosis:
Caregivers and teachers typically suspect learning disabilities once a
child is in school. Your child will need to go through special
assessments and tests so that a professional can make a diagnosis.
Your child’s pediatrician and a school psychologist or child
psychologist will be involved in the process.
It’s important to note that a psychologist diagnoses a learning
disorder. Your child’s school may identify a learning disability and
then act accordingly to do an evaluation and develop a learning plan.
The process for a psychological diagnosis and a legal identification
per the Individuals with Disabilities Education Act (IDEA) are slightly
different. But they typically involve a combination of:
1) Observations.
2) Interviews.
3) Assessments.
4) Medical and family history.
5) School reports.
You’ll work closely with your child’s school personnel and education
specialists during this process.
Learning disability assessments:
Types of evaluations for learning disabilities each of which use
different assessments or tests, include:
1. Medical evaluation: To start, your child’s pediatrician will do a
physical exam and a neurological exam to make sure your
child’s learning challenges aren’t due to an underlying medical
condition. They may recommend certain tests, like blood tests
or imaging tests.
2. Educational assessment and performance evaluation: Your
child’s teacher(s) will observe their behavior in the classroom
and assess their academic performance. They’ll evaluate your
 child’s reading, writing and math skills based on their grade
level and provide notes.
3. Cognitive evaluation: This evaluation typically includes verbal
and nonverbal intelligence (IQ) testing. Your child will see their
school psychologist or a child psychologist for it. They may also
evaluate your child’s preferred way of processing information
— like visually or aurally, for example.
4. Psychological evaluation: This evaluation helps identify ADHD,
oppositional defiant disorder, anxiety disorders, depression and
confidence issues. These frequently accompany — but are
distinct from — learning disabilities. A child psychologist will
assess your child’s attitude toward school, motivation level,
peer relationships and self-confidence.
5. Neuropsychological assessment: This testing assesses how
brain conditions may affect your child’s behavior and cognitive
skills (how your child uses their brain). A neuropsychologist
does this assessment. It’s particularly useful in children with
known central nervous system injuries or illnesses for mapping
areas of their brains that correspond to specific learning
strengths and weaknesses.

Prognosis:
Even though children don’t outgrow learning disabilities, they can
learn to adapt and improve their skills. Children who receive early
diagnoses and interventions are more likely to overcome challenges
while maintaining a positive self-image.

They may also build on personal strengths that tend to come with
learning disorders. For example, people with dyslexia are often
especially creative. Children with learning disabilities can grow to
become very productive and successful adults.

Interventions:
Interventions for learning disabilities (LDs) are designed to help
individuals overcome challenges in academic, social, and emotional
areas. They can be tailored to the specific learning disability (e.g.,
dyslexia, dysgraphia, dyscalculia, ADHD) and the individual's needs.

Importance of Early Identification and Intervention:

Early diagnosis is critical. The sooner interventions begin, the better
the outcomes for academic and personal success.

Here's a broad overview:

1. Educational Interventions:

These are strategies and accommodations designed to enhance

learning in school environments.

 Individualized Education Plans (IEPs): Customized learning plans

for students with diagnosed learning disabilities.
 Multisensory Teaching Techniques: Incorporating visual,
auditory, and kinesthetic activities for effective learning.
Example: Using sandpaper letters to teach spelling (touch and
sight).
 Special Education Programs: Small group instruction focused on
specific skills like reading, writing, or math.
 Assistive Technology: Tools like speech-to-text software,
audiobooks, and calculators.
 Explicit Instruction: Step-by-step teaching that is clear and
structured.

2. Behavioural and Emotional Interventions:

These address the emotional and social challenges often associated

with LDs.

 Social Skills Training: Helps individuals develop communication,

teamwork, and problem-solving skills.
  Cognitive-Behavioral Therapy (CBT): Teaches strategies for
managing frustration, anxiety, and low self-esteem.
 Positive Reinforcement: Rewarding effort and achievements to
build confidence and motivation.

3. Therapy-Based Interventions:

Some learning disabilities benefit from therapies targeting specific

deficits.

 Speech and Language Therapy: For individuals with language-

processing disorders or difficulty with communication.
 Occupational Therapy (OT): Enhances fine motor skills,
handwriting, and organization.
 Physical Therapy: Addresses gross motor difficulties that may
affect physical coordination.

4. Parental and Family Support: Family involvement is crucial for

successful interventions.

 Parent Training Programs: Help parents understand the

disability and implement effective strategies at home.
 Consistent Routines: Providing structure and predictable
schedules to reduce stress.
 Advocacy Skills: Equipping parents to work with schools and
advocate for accommodations.

5. Academic Support Outside School: Support outside traditional

classrooms can make a big difference.

 Tutoring: Specialized tutors trained in teaching methods for LDs

(e.g., Orton-Gillingham for dyslexia).
 Learning Centers: Centers offering programs specifically
designed for individuals with LDs.
 Summer Camps and Workshops: Programs focusing on specific
skills while boosting self-esteem.
6. Lifestyle and Environmental Changes: Creating a supportive
environment enhances learning and reduces frustration.

 Quiet Workspaces: Minimizing distractions during study time.

 Time Management Tools: Using planners, timers, and checklists
to organize tasks.
 Breaks and Physical Activity: Incorporating regular breaks and
exercise to improve focus.

7. Peer and Community Support: Engaging with others who share

similar challenges can foster belonging and support.

 Support Groups: For both individuals with LDs and their

families.
 Mentorship Programs: Pairing individuals with mentors who
have successfully managed their LDs.

8. Pharmacological Interventions (When Appropriate): In some

cases, medications may help manage symptoms of conditions like
ADHD that often coexist with learning disabilities.